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  • Title: The feasibility and effect of a nurse-led, patient-centered asthma education program in a Nigerian context.
    Author: Ozoh OB, Akinbolagbe Y, Tekobo A, Dede SK, Dania MG, Adeyeye O.
    Journal: J Asthma; 2022 Aug; 59(8):1670-1679. PubMed ID: 34121580.
    Abstract:
    RATIONALE, AIMS AND OBJECTIVES: Insufficient asthma education is an unmet need in Nigeria. We aimed to assess the feasibility of a nurse-led asthma education program and its effect on asthma knowledge and outcomes in Lagos, Nigeria. METHODS: Using a quasi-experimental study design, we recruited participants ≥12 years with physician diagnosed asthma. We assessed asthma knowledge, asthma control, medication adherence, health related quality of life and inhaler technique and also measured lung function. A trained nurse delivered asthma education sessions during the regular clinic visits and demonstrated correct inhaler technique. All assessments were repeated at 3-month. Data was analyzed with descriptive and inferential statistics. A p-value of <0.05 was considered significant for all associations. RESULTS: Of the 80 participants at baseline, 42 (52.5%) completed the follow-up assessment and were included in the outcome analysis. Their ages ranged from 12 to 75 years, 35 (83.3%) were ≥18 years old and 30 (71.4%) were females. There was significant improvement in knowledge score immediately post intervention (15.48 ± 3.05 versus 18.33 ± 2.21, p < 0.001) and at 3 months (17.52 ± 2.63, p < 0.001). Those with uncontrolled asthma (Asthma Control Test score ≤19) had a meaningful (3.8-point) change in ACT score at follow-up. The improvement in the mean score on the Morisky Medication Adherence Scale was significant (p = 0.03), but a change of 0.48 was not considered meaningful. There was significant (p < 0.001) and meaningful (1.08) improvement in Mini Asthma Quality of Life score at 3 months. Pre-bronchodilator FEV1% predicted and scores on the inhaler technique check list for the Diskus and pressurized meter dose inhaler did not significantly change at follow-up (p = 0.38, 0.26 and 0.80 respectively). CONCLUSION: It is practicable for nurses to deliver effective asthma education during regular clinic visits in our practice setting. This training could meaningfully improve asthma control and health related quality of life.
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